Tectonic and Therapeutic Urgent Penetrating Keratoplasty Outcomes.

Objectives: It was aimed to to provide a comprehensive assessment of therapeutic and tectonic emergency keratoplasty procedures, along with a discussion on their indications, prognostic factors for functional success, and postoperative outcomes. Methods: Patients who underwent therapeutic or tectonic Penetrating Keratoplasty (PKP) procedures between 2010 to 2021 in our hospital were retrospectively reviewed. Patient files were evaluated in terms of demographic characteristics, medical and ocular history, visual acuity, initial ocular findings, presence of glaucoma, causative microorganisms, details of surgical procedures, complications, graft transparency and globe integrity. Visual acuity was measured as light perception, hand motion, counting finger, Snellen chart and subsequently converted to Logarithm of the Minimum Angle of Resolution (logMAR) for statistical analysis. Results: The study included a total of 43 patients, with 16 (37.2%) being female. The average age of the participants was 59.72±18.1 years. The corrected distance visual acuity improved from 2.3±0.66 logMAR preoperatively to 1.72±1.02 logMAR postoperatively (p=0.001). After PKP, anatomical success was achieved in all eyes and functional success was achieved in 23 (51.1%) eyes. It was observed that only preoperative glaucoma had a significant impact on graft survival rate (p=0.002, Figure 2), as well as functional success (p=0.022). Conclusion: Urgent keratoplasty is a viable treatment option for cases involving an actively uncontrolled infection or corneal disease with perforation. In cases of graft rejection, bacteria, fungi, and viral pathogens were detected as causative agents, whereas only bacteria were detected as the causative agents in cases of pre and post-operative endophthalmitis. Early diagnosis and treatment play crucial roles in achieving anatomical and functional success.

Analysis of Corneal and Lens Densitometry Changes in Patients With Type 1 Diabetes Mellitus.

PURPOSE: By comparing the densitometry findings of patients with type 1 diabetes mellitus (T1DM) and the healthy group, we aimed to understand the possible changes that may occur in the cornea and lens in those with diabetes mellitus (DM). DESIGN: Prospective, cross-sectional study. METHODS: A total of 60 eyes of 60 patients with T1DM and 101 eyes of 101 healthy subjects were included in this study. A complete ophthalmologic evaluation was performed in all participants. Scheimpflug tomography was performed to record the corneal and lens densitometry and other tomographic data. Mean glycosylated hemoglobin (HbA1c) and mean DM duration were recorded. RESULTS: The mean age of the patients with T1DM and patients in the control group was 29.93 ± 8.56 years and 27.27 ± 1 4.96 years, respectively. The mean HbA1c was 8.43 ± 1.92, and the mean DM duration was 14.10 ± 7.77 years. Corneal densitometry (CD) values were significantly higher in the 0- to 2-mm zone in all layers and in the anterior and central 6- to 10-mm zone in the diabetic group (P = .03, P = .018, P = .001, P = .000, P = .004). The mean crystalline lens densitometry was higher in the T1DM group (P = .129). There were positive correlations between DM duration and CD in the anterior 0- to 2-mm (P = .043), central 6- to 10-mm (P = .016), posterior 6- to 10-mm (P = .022), and posterior 10- to 12-mm zone (P = .043). CONCLUSIONS: CD values were significantly higher in the diabetic group. Diabetes duration and HbA1c values showed correlations with densitometry especially in the 6- to 10-mm corneal zone. Evaluation of the cornea with optical densitometry will be useful in the early diagnosis and follow-up of clinical structural and functional changes in the cornea.

Treatment results of diabetic macular edema with different choroidal thickness with intravitreal anti vascular endothelial growth factor.

PURPOSE: To compare the results of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with diabetic macular edema (DME) with different choroidal thicknesses. METHODS: The files of patients diagnosed with DME and treated with intravitreal anti-VEGF were reviewed retrospectively. The best-corrected visual acuity (BCVA), choroidal thickness (CT), and macular thickness (MT) measurements were recorded before and after treatment. All patients included in the study were divided into 3 groups according to the initial subfoveal choroidal thickness (SFCT). Group 1 included 35 patients with SFCT ≤ 220, group 2 included 27 patients with SFCT > 220 ≤ 270, and group 3 included 30 patients with SFCT > 270. The total number of anti-VEGF administered during the follow-up at the last examination, baseline and post-treatment CT, MT, and BCVA measurements were statistically compared in all 3 groups. RESULTS: The mean age of the patients was 61.9 ± 10.2 in group 1, 58.7 ± 8.7 in group 2, and 57.0 ± 6.5 in group 3. The mean anti-VEGF count in group 1 was significantly lower than group 2 and group 3 (p = 0.004, p = 0.006). In Group 1, BCVA improved significantly after treatment compared to baseline (p = 0.001). In Groups 2 and 3, BCVA did not change significantly after treatment compared to baseline (p = 0.320, p = 0.104). After treatment, central macular thickness decreased significantly in group 1 compared to baseline, while central macular thickness did not show a significant change from baseline in group 2 and group 3 after treatment (p = 0.003, p = 0.059, p = 0.590). CONCLUSION: In our study, we observed that the treatment needs of our DME patients with different choroidal thicknesses were different. In patients with DME, the initial choroidal thickness may help determine the need for follow-up and treatment.